Future of Sclerotherapy in the Treatment of Endometriosis: A Narrative Literature Review.

Endometriosis is a gynaecological condition affecting reproductive-age women. In case of ovarian endometriosis, there is cystic formation, called endometrioma. Although laparoscopic cystectomy is established as the gold standard for the treatment of endometriomas, it is related to damage of healthy ovarian tissue and significant decrease in ovarian reserve. As a result, new strategies have been set for the care of endometriomas, with ethanol sclerotherapy as the most popular alternative. As a part of sclerotherapy, ethanol solution is injected to destroy pseudocapsule. Iatrogenic damage is minimized, making it a safe and less invasive technique. In this study, we compared ultrasound-guided (U/S) ethanol sclerotherapy and laparoscopic ethanol sclerotherapy with laparoscopic cystectomy. Anti-Müllerian hormone (AMH) is used to monitor ovarian preservation. Sclerotherapy seems to have smaller effect on ovarian reserve compared to cystectomy. Recurrence rate and clinical pregnancy rate are similar, though cystectomy has better outcome of symptom relief. Moreover, laparoscopic sclerotherapy seems to achieve the best clinical pregnancy rate and decrease recurrence rate.